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Two Questions For Your Doctor Before A Colonoscopy
by Michelle Andrews
Cancer prevention guidelines recommend that men and women get screened for colorectal cancer every 10 years between the ages of 50 and 75.
Colonscopy is the usual approach, but only 59 percent of people who should be screened get the tests, according to the American Cancer Society.
No wonder. Colonoscopy involves inserting a tube equipped with a lighted camera into your rear end and snaking it through the length of the colon looking for fleshy masses called polyps that may be cancerous or become cancerous.
Before the test, patients must take laxatives to ensure their bowel is empty. As clinicians sometimes say, between the bowel preparation and the test itself, the "ick" factor is pretty high.
Unfortunately, unless the test is performed by a skilled physician with a good record of detecting polyps, all that effort may be wasted. "The biggest problem with colonoscopy is that it's operator dependent," says Dr, Douglas Rex, director of endoscopy at Indiana University Hospital.
A skilled physician should have a polyp detection rate of about 25 percent for men and 20 percent for women, says Dr. Durado Brooks, director of prostate and colorectal cancers for the American Cancer Society. Those figures correspond to the percentages of men and women over 50 who have polyps.
Another key indicator is the "colonoscopy withdrawal time," which measures how long a physician takes to remove the scope after reaching the beginning of the colon. Longer is better, within reason. A withdrawal time of at least six minutes is associated with higher detection rates. Ten minutes is optimal, according to an analysis published last year.
"The colon is a very twisted organ, and you may see things on the way out that were missed on the way in," says Brooks.
Don't be shy. To make sure you're getting the most out of your once-a-decade screening test, quiz your gastroenterologist about those two measures, says Brooks.
http://www.npr.org/blogs/health/2012/06/05/154346913/two-questions-for-your-doctor-before-a-colonoscopy
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Health Q&A: Colonic irrigation
Britain's leading health and wellbeing specialists answer your questions
How safe is colonic irrigation? I have friends who swear by it as a cure for irritable bowel syndrome (IBS), but I've also read that it gets rid of important 'friendly' bacteria in the gut. Does it benefit people with digestive problems and if so how often is it recommended?
THE GP Rupal Shah
There is no evidence that colonic irrigation is effective at treating IBS, or indeed any other medical condition. The idea that 'detoxification' is somehow beneficial goes very much against mainstream medical thinking. The colon naturally eliminates waste material and absorbs water and electrolytes, and colonic irrigation has the potential to disturb this balance, leading to dehydration and salt depletion.
THE REGISTERED DIETICIAN Nigel Denby
While there is no evidence to suggest that having a colonic is particularly dangerous, there's nothing to support the idea that it will really do you any good, either. The same goes for other 'cleansing' treatments – detox clinics and so on. Our body is perfectly well equipped to do all of these things itself, and forcing the process is likely to give psychological satisfaction rather than any physiological boost.
THE NUTRITIONAL THERAPIST Melanie Brown
Colonic irrigation is based on the theory that impacted faecal waste causes 'auto-intoxication' but there is no evidence supporting this. The delicate ecosystem of bacteria is almost certainly disrupted so re-population with probiotics is essential. Electrolyte balance may be affected and vitamins B and K, made by gut bacteria, lost. It is an invasive treatment so finding a qualified, experienced therapist is vital.
http://www.telegraph.co.uk/health/healthadvice/9280072/Health-QandA-Colonic-irrigation.html
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More Antibiotic Use Tied to Rise in Diarrheal Infections in Hospitals
Study Finds Kids, elderly especially vulnerable to serious consequences from C. difficile bacteria
MONDAY, Oct. 22 (HealthDay News) -- Greater use of antibiotics is the main reason for an increase in the number and severity of Clostridium difficile infections among hospitalized children and elderly people, researchers report.
This type of bacteria is the most common cause of diarrhea in hospitals and is linked to 14,000 deaths in the United States each year.
For the study, Mayo Clinic researchers analyzed national data from about 13.7 million children who were hospitalized over a five-year period and found that the more than 46,000 with C. difficile infections had much longer hospital stays, were more likely to require partial or total removal of the colon, were more likely to be admitted to long- or short-term care facilities and had a higher risk of death.
"Despite increased awareness of C. difficile in children, and advancements in management and prevention, this remains a major problem in hospitalized children," gastroenterologist Dr. Sahil Khanna, said in a Mayo Clinic news release.
The researchers also looked at data from 1.3 million hospitalized adults with C. difficile infections and found that those over 65 spent more time in the hospital, were more likely to be sent to a nursing home and had a greater risk of death.
These findings suggest that being over age 65 is an independent risk factor for poorer outcomes among adults with C. difficile infection, the researchers said.
The study authors said that greater use of antibiotics is the main reason for the growing number of C. difficile infections. This is because antibiotics destroy the good bacteria that protect against infections.
The study was scheduled for presentation at the American College of Gastroenterology's annual meeting in Las Vegas. The data and conclusions of research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.
More information
The U.S. Centers for Disease Control and Prevention has more about C. difficile infection.
-- Robert Preidt
SOURCE: Mayo Clinic, news release, Oct. 22, 2012
Last Updated: Oct. 22, 2012
Copyright © 2012 HealthDay. All rights reserved.
http://consumer.healthday.com/Article.asp?AID=669894
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By Will Boggs, MD
NEW YORK (Reuters Health) Feb 05 - Overweight patients troubled by gastroesophageal reflux will do better if they slim down, a new study shows.
In Norway's population-based HUNT study, weight loss was linked with a reduction in reflux symptoms and better results with antireflux medication.
"Clinicians working with these patients often tell that their patients get more complaints with increasing weight and that the complaints are reduced with weight loss," Dr. Eivind Ness-Jensen from the Norwegian University of Science and Technology in Levanger told Reuters Health. "However, the scientific evidence has not been conclusive."
In a study reported January 29th online in The American Journal of Gastroenterology, Dr. Ness-Jensen and colleagues looked at data on 9,299 participants in the ongoing cohort study who had any reflux symptoms, plus 1,553 individuals with severe symptoms.
In crude analyses, weight loss was dose-dependently associated with loss or reduction of reflux symptoms. For participants who used antireflux medication less than once a week (or not at all), resolution was twice as likely among those who lost more than 3.5 units of body mass index (BMI) compared with those who lost less than 0.5 unit of BMI.
Among those taking antireflux medication at least weekly, the corresponding increase in the likelihood of symptom resolution was nearly fourfold.
Results differed for individuals with severe symptoms. In this subset, weight loss didn't seem to matter in patients who used antireflux medication less than once a week. But for patients who used the medicines at least weekly, the chances of symptom reduction and resolution improved 2.12-fold and 3.11-fold, respectively.
"Most agree that overweight is a risk factor of gastroesophageal reflux symptoms (GERS), but if weight loss reduces GERS has not been clear," Dr. Ness-Jensen said. "We have shown in a large, unselected population that weight loss is associated with improvement in GERS and that a larger weight loss is associated with an increased chance of improvement."
Patients who are overweight should be encouraged to lose weight, "as this might reduce their symptoms and reduce the need for medication," he said.
Dr. Ness-Jensen also noted some hazards of long-term reflux medications. Not only is there an expense to the patient and to society, he said, but "long-term treatment with proton pump inhibitors is also associated with several side effects, including increased risk of pneumonia, enteral infections (especially Clostridium difficile), and hip fractures (due to malabsorption of calcium)."
On the other hand, Dr. Ness-Jensen concluded, "weight loss could reduce the need for long-term treatment, and lifestyle intervention and weight loss are beneficial for the general health."
SOURCE: http://bit.ly/TFlCAR
Am J Gastroenterol 2013.
http://www.medscape.com/viewarticle/778780?pa=vbB8eIQy0Iujsdi3U2lhucPsMsV1VmOiJHeuM6wcQX3bdP7wZmZTAZUQaKSkNmPw8SIvl8zjYv73GUyW5rsbWA%3D%3D
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IBS increased risk for osteoporosis, related fractures
November 6, 2012
LAS VEGAS — Patients with IBS are more likely to develop osteoporosis and are at increased risk for osteoporosis-related fractures, according to data presented at the 2012 American College of Gastroenterology Annual Scientific Meeting.
The study included 317,857 emergency department visits for patients with secondary IBS diagnoses, collected from the 2008 Nationwide Emergency Department Sample database, and compared them with controls without IBS. The presence of and risk for osteoporosis and related fractures within the IBS cohort was evaluated, along with potential predictive factors. Analysis included pathologic wrist, vertebrae and femur fractures and traumatic wrist, vertebrae and hip fractures.
Within the assessed cohort, 17,752 patients had an osteoporosis diagnosis, with concurrent fracture diagnoses in 2,197 cases. Risk for osteoporosis was elevated among patients with IBS (OR=4.28; 95% CI, 4.21-4.35), as was risk for osteoporotic fracture (OR=2.36; 95% CI, 2.26-2.47) compared with controls.
Osteoporosis risk was higher in the IBS cohort regardless of age or sex, but the increase was less pronounced among older patients. Investigators calculated ORs of 4.86 (3.09-7.65) for males and 4.46 (3.78-5.25) for females aged 0 to 40 years; 4.98 (4.31-5.75) for males and 3.55 (3.43-3.68) for females aged 41 to 65 years, and 3.08 (2.81-3.39) for males and 2.79 (2.73-2.84) for females aged 66 and older (95% CI for all).
Fractures of the vertebrae, hip and wrist were more likely among patients with IBS, with the greatest risk increase for wrist fractures (OR=2.41, 2.10-2.77). Patients with IBS were at greater risk for hip and wrist fractures than patients with either Crohn's disease (OR=1.47, 1.28-1.69 for hip fractures; OR=1.6, 1.20-2.14 for wrist fractures) or ulcerative colitis (OR=1.55, 1.31-1.83 for hip; OR=0.7, 0.41-1.22 for wrist fractures).
"In gastroenterology, we are cognizant of the fact that some of our patients with chronic GI diseases are at higher risk for osteoporosis," researcher Eli D. Ehrenpreis, MD, head of the division of gastroenterology at NorthShore University HealthSystem, told Healio.com. "We've been very well-educated about that risk in patients with IBD and celiac disease. … Our study identifies IBS as a significant risk factor for osteoporosis and for bone fracture. Those patients should be screened for the development of osteoporosis, and should be advised about their increased risk of osteoporosis and bone fracture."
For more information:
Stobaugh DJ. P1016: Increased Risk of Osteoporosis-Related Fractures in Patients with Irritable Bowel Syndrome. Presented at: the 2012 American College of Gastroenterology Annual Scientific Meeting; Oct. 19-24, Las Vegas.
http://www.healio.com/gastroenterology/irritable-bowel-syndrome/news/online/%7Bf39f2725-01d2-4e47-85d0-131cb1057cf4%7D/ibs-increased-risk-for-osteoporosis-related-fractures
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http://www.govtrack.us/congress/bills/112/hr2239
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Chronic Heartburn May Raise Odds for Throat Cancer: Study
But simple antacids appear to lower the risk, researchers report
May 23, 2013
By Steven Reinberg
HealthDay Reporter
THURSDAY, May 23 (HealthDay News) -- People who suffer from frequent heartburn may be at increased risk for cancers of the throat and vocal cords even if they don't smoke or drink alcohol, a new study says.
Interestingly, common over-the-counter antacids seemed to protect against these cancers while prescription medications such as Prilosec, Nexium and Prevacid didn't, the researchers said.
"There has been a controversy about whether heartburn contributes to cancers of the larynx or pharynx," said lead researcher Scott Langevin, a postdoctoral research fellow at Brown University in Providence, R.I.
"And we found out that it does elevate the risk of these cancers. There is about a 78 percent increase in the risk for cancer in people who experience heavy heartburn," he said. "This is important in figuring out who to monitor more closely."
The other finding, which Langevin called "surprising," was the protective effect of common antacids in reducing the risk of cancer.
"We didn't see that protective effect with prescription medications. But it should be noted that people who take them are those who get the worst heartburn, so we shouldn't read too much into that," he said.
Langevin added that it's hard to explain that medication finding, and other studies will be needed to see if it's really the case. "It's possible that these drugs didn't have that protective effect because these were the worst cases of heartburn," he said.
The report was published May 23 in the journal Cancer Epidemiology, Biomarkers & Prevention. And while it uncovered an association between heartburn and cancer of the throat and vocal cords, it didn't prove a cause-and-effect relationship.
Dr. Len Lichtenfeld, deputy chief medical officer at the American Cancer Society, said "the study shows that reflux is associated with an increased incidence of cancers of the larynx and pharynx."
Lichtenfeld said the role of antacids in reducing the risk of cancer needs more study. "Researchers need to determine why antacids work and, more importantly, whether antacids make a difference in also reducing cancer of the esophagus," he said.
Why other medications didn't lower the risk isn't clear, Lichtenfeld said. And it points to one limitation of this type of study: It can't take into account all the variables.
To come to their conclusions, Langevin's group compared more than 600 patients with throat or vocal cord cancer with more than 1,300 people without a history of cancer. All the patients answered questions about their history of heartburn, smoking and drinking habits, and family history of cancer.
In addition, since some head and neck cancers are caused by the human papillomavirus (HPV), the researchers tested all the participants for antigens to the virus.
The researchers found that among those who weren't heavy smokers or drinkers, frequent heartburn increased the risk for cancers of the throat and vocal cords by 78 percent.
The researchers also found that taking antacids -- but not prescription medications or home remedies -- reduced the risk for these cancers by 41 percent. The protective effect of antacids was independent of smoking, drinking or infection with HPV, they said.
More information
For more information on throat cancer, visit the American Cancer Society.
Copyright © 2012 HealthDay. All rights reserved.
http://health.usnews.com/health-news/news/articles/2013/05/23/chronic-heartburn-may-raise-odds-for-throat-cancer-study
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Hot Summer Weather and IBS
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IBS Quick Tip - Bloating Relief
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Had your gallbladder out? You may not have IBS.
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Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!
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